Body Positioning in X-Ray Stu... Health Article

Body habitus

The body habitus describes the basic body shape. Body shape is important in x-ray exams as the size, shape, and position of the organs varies by body type. The technologist should adjust the x-ray unit accordingly, in order to obtain an adequate image. There are four terms used to describe body habitus:

• Hyperstenic (large to massive). Chest and abdomen are broad and deep, lungs are short, diaphragm is high.
• Stenic (average).
• Hypostenic (slender).
• Asthenic (very slender). Chest is narrow, shallow, and long so diaphragm is low.

In the hyperstenic patient, the stomach typically lays across the abdomen at or above waist level. The stomach of a stenic patient is shaped like a comma laying slightly skewed from left to right and centered at the waistline. The stomach of a hypostenic patient is elongated into a "J" shape and may extend into the pelvis. Since the astenic patient appears to have little abdominal space between the diaphragm and pelvis, the stomach is quite long and slender lying primarily in the pelvis. An understanding of body habitus and the relationship of the organs in the chest, abdomen, and pelvis are essential in positioning for upper and lower gastrointestinal exams. In addition, other positioning considerations are important, including posture, respiration, and stomach contents.

Preparation

Most x-ray exams require little if any preparation by the patient. In many cases, the change from street clothes to a hospital gown is all that is required. Some exams may require the patient to fast for several hours while others may require ingestion of a radiopaque liquid that will define the gastrointestional system in the radiographs. Special imaging procedures such as nuclear medicine, sonography, or magnetic resonance imaging may have additional preparation requirements.

Aftercare

Few x-ray examinations require aftercare. If the examination required an injection of medication or contrast media, instructions will be given about the contrast and care of the puncture site. Following examination of the gastrointestinal system, patients are typically instructed to drink plenty of fluids and are advised how the exam may affect bowel movements.

Complications

Complications following x-ray exams are rare. If an injection is required or catheter is used, there may be the typical complications at the puncture site-bruising, bleeding, and discomfort. Patients should be advised of the possibility of complications from their exam, preferably in writing.

Health care team roles

Although the radiographer actually performs the examination in most cases, there are other members of the health care team in the radiology department or imaging center. Many facilities have transport personnel whose job it is to move patients in and out of the imaging rooms and department. These individuals are trained in the safe handling of patients and support equipment as well as proper lifting techniques and universal precautions against infections. Many hospitals provide a radiology nurse to perform injections, assist the physician in special procedures, or provide patient care as required. The radiologist will interpret the resulting images.

KEY TERMS

Articulation—A joint, a connection between bones.

Orthogonal planes—Intersecting planes, planes at right angles to each other.

Position—A body posture such as upright, recumbent, supine, prone, lateral, also the description of the posture of an anatomical part such as oblique.

Radiograph—X-ray image, either physical (on film or paper) or digital.

Radiographer—Allied health professional who performs diagnostic imaging exams using x rays, magnetic resonance imaging, computed tomography, sonography, and others.

BOOKS

Ballinger, Philip W., Frank, Eugene D. Merrill's Atlas of Radiographic Positions and Radiologic Procedures. St. Louis, MO: Year Book Medical Publishing, 1999.

Bontrager, Kenneth L. Bontrager's Pocket Atlas: Handbook of Radiographic Positioning and Related Anatomy. Peoria, AZ: Bontrager Publishing Inc. 1995.

PERIODICALS

Ballinger, Philip W., Glassner, Jeffrey L. "Positioning Competencies for Radiography Graduates." Radiologic Technology (Nov 1998):181.

Bello, Alberto Jr. "An Alternative Positioning Landmark." Radiologic Technology 70, no. 5 (May 1999):477.

Peters, Richard, Sikorski, Robert. "The X (ray) Files: Radiology Resources on the Internet." JAMA, The Journal of the American Medical Association 279, no. 7 (Feb 18, 1998):561.

"Recommended Practices for Reducing Radiological Exposure in the Practice Setting." AORN Journal 73, no. 1 (Jan 2001):220.

"Shields and Radiation Safety." Radiologic Technology 71, no. 2 (Nov 1999):224.

Tilson, Elwin R., Rodgers, Anne T., Cross, Deanna S., Tanenbaum, Barbara G. "Internet Listservers in Radiology." Radiologic Technology 69, no. 3 (Jan-Feb1998):267.

ORGANIZATIONS

American Registry of Radiologic Technologists. 1255 Northland Drive. St. Paul, MN 55120-1155. <http://www.arrt.org>.

American Society of Radiologic Technologists. 15000 Central Ave. SE. Albuquerque, NM 87123-3917. 505-298-4500. 800-444-2778. Fax 505-298-5063. <http://www.asrt.org>.

Radiological Society of North America. 820 Jorie Boulevard. Oak Brook, IL 60523-2251. (630) 571-2670. Fax (630) 571-7837. <http://www.rsna.org>.

Elaine R. Proseus, MBA/TM, BSRT, RT(R)